The treatment of varus knee osteoarthritis by high tibial osteotomy combined with arthroscopic knee debridement

XIE Kun-nan; ZHAO Ri-an; DAI Shi-feng; WANG Ping; ZHANG Qi-xian

doi:10.16048/j.issn.2095-5561.2025.04.06

Abstract：Objective To investigate the clinical efficacy of high tibial osteotomy(HTO)combined with arthroscopic debridement of the knee joint in the treatment of varus knee osteoarthritis.Methods A total of 115 patients with varus knee osteoarthritis admitted to the Second Hospital of Tangshan from January 2022 to June 2023,including 51 males and 64 females,aged(56.57±5.92)years old and ranging from 45 to 65 years old.Based on the surgical approach,patients were divided into the HTO group(n=65)and HTO combined with arthroscopic group(n=50).The HTO group was treated with HTO,and the HTO combined with arthroscopic group was treated with HTO combined with arthroscopic debridement of the knee joint.The perioperative indicators were recorded and compared between the two groups,including surgical duration,intraoperative blood loss,length of hospital stay,time to weight-bearing ambulation and healing time of the osteotomy site.The Hospital for Special Surgery(HSS)score,Lysholm score,visual analogue scale(VAS)score,medial proximal tibial angle(MPTA),and femoral-tibial angle(FTA)before the operation,6 months after the operation and 12 months after the operation were recorded and compared between the two groups.The occurrence of complications in the two groups were observed.Results There were no statistically significant differences in perioperative indicators between the two groups(P＞0.05).Before the surgery,there were no statistically significant differences between the two groups in HSS score,Lysholm score,VAS score(P＞0.05).At 6 and 12 months after the operation,HSS score,Lysholm score,VAS score of the two groups were higher than those before the operation,moreover,the HSS score and Lysholm score in the HTO combined with arthroscopy group were higher than those in the HTO group,and the differences were statistically significant(P＜0.05).At 6 and 12 months after the operation,the pain VAS score of the two groups were lower than that before the operation,and the VAS score of the HTO combined with arthroscopy group was lower than that in the HTO group,and the differences were statistically significant(P＜0.05).Before the operation,6 months after the operation and 12 months after the operation,there were no statistically significant differences in MPTA and FTA between the two groups(P＞0.05).At 6 months and 12 months after the operation,the MPTA of the two groups was higher than that before the operation,and the FTA of the two groups was lower than that before the operation,and the differences were statistically significant(P＜0.05).No obvious complications occurred in the two groups.Conclusion Compared with HTO alone,HTO combined with arthroscopic debridement of the knee joint can significantly improve knee function,reduce knee pain,and achieve similar correction of lower limb alignment in patients with varus knee osteoarthritis.